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Issue Cover for Volume 9, Number 4—April 2003

Volume 9, Number 4—April 2003

[PDF - 8.03 MB - 110 pages]

Perspective

Bacterial Resistance to Penicillin G by Decreased Affinity of Penicillin-Binding Proteins: A Mathematical Model [PDF - 377 KB - 7 pages]
L. Temime et al.

Streptococcus pneumoniae and Neisseria meningitidis have very similar mechanisms of resistance to penicillin G. Although penicillin resistance is now common in S. pneumoniae, it is still rare in N. meningitidis. Using a mathematical model, we studied determinants of this difference and attempted to anticipate trends in meningococcal resistance to penicillin G. The model predicted that pneumococcal resistance in a population similar to that of France might emerge after 20 years of widespread use of β-lactam antibiotics; this period may vary from 10 to 30 years. The distribution of resistance levels became bimodal with time, a pattern that has been observed worldwide. The model suggests that simple differences in the natural history of colonization, interhuman contact, and exposure to β-lactam antibiotics explain major differences in the epidemiology of resistance of S. pneumoniae and N. meningitidis.

EID Temime L, Boëlle P, Courvalin P, Guillemot D. Bacterial Resistance to Penicillin G by Decreased Affinity of Penicillin-Binding Proteins: A Mathematical Model. Emerg Infect Dis. 2003;9(4):411-417. https://dx.doi.org/10.3201/eid0904.020213
AMA Temime L, Boëlle P, Courvalin P, et al. Bacterial Resistance to Penicillin G by Decreased Affinity of Penicillin-Binding Proteins: A Mathematical Model. Emerging Infectious Diseases. 2003;9(4):411-417. doi:10.3201/eid0904.020213.
APA Temime, L., Boëlle, P., Courvalin, P., & Guillemot, D. (2003). Bacterial Resistance to Penicillin G by Decreased Affinity of Penicillin-Binding Proteins: A Mathematical Model. Emerging Infectious Diseases, 9(4), 411-417. https://dx.doi.org/10.3201/eid0904.020213.
Research

The Elderly and Waterborne Cryptosporidium Infection: Gastroenteritis Hospitalizations before and during the 1993 Milwaukee Outbreak [PDF - 346 KB - 9 pages]
E. N. Naumova et al.

We used the Temporal Exposure Response Surfaces modeling technique to examine the association between gastroenteritis-related emergency room visits and hospitalizations in the elderly and drinking water turbidity before and during the 1993 Milwaukee waterborne Cryptosporidium outbreak. Before the outbreak, the rate of such events increased with age in the elderly (p<0.002), suggesting that the elderly are at an increased risk. During the outbreak, strong associations between turbidity and gastroenteritis-related emergency room visits and hospitalizations occurred at temporal lags of 5–6 days (consistent with the Cryptosporidium incubation period). A pronounced second wave of these illnesses in the elderly peaked at 13 days. This wave represented approximately 40% of all excess cases in the elderly. Our findings suggest that the elderly had an increased risk of severe disease due to Cryptosporidium infection, with a shorter incubation period than has been previously reported in all adults and with a high risk for secondary person-to-person transmission.

EID Naumova EN, Egorov AI, Morris RD, Griffiths JK. The Elderly and Waterborne Cryptosporidium Infection: Gastroenteritis Hospitalizations before and during the 1993 Milwaukee Outbreak. Emerg Infect Dis. 2003;9(4):418-425. https://dx.doi.org/10.3201/eid0904.020260
AMA Naumova EN, Egorov AI, Morris RD, et al. The Elderly and Waterborne Cryptosporidium Infection: Gastroenteritis Hospitalizations before and during the 1993 Milwaukee Outbreak. Emerging Infectious Diseases. 2003;9(4):418-425. doi:10.3201/eid0904.020260.
APA Naumova, E. N., Egorov, A. I., Morris, R. D., & Griffiths, J. K. (2003). The Elderly and Waterborne Cryptosporidium Infection: Gastroenteritis Hospitalizations before and during the 1993 Milwaukee Outbreak. Emerging Infectious Diseases, 9(4), 418-425. https://dx.doi.org/10.3201/eid0904.020260.

Costs of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin [PDF - 231 KB - 6 pages]
P. S. Corso et al.

To assess the total medical costs and productivity losses associated with the 1993 waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, including the average cost per person with mild, moderate, and severe illness, we conducted a retrospective cost-of-illness analysis using data from 11 hospitals in the greater Milwaukee area and epidemiologic data collected during the outbreak. The total cost of outbreak-associated illness was $96.2 million: $31.7 million in medical costs and $64.6 million in productivity losses. The average total costs for persons with mild, moderate, and severe illness were $116, $475, and $7,808, respectively. The potentially high cost of waterborne disease outbreaks should be considered in economic decisions regarding the safety of public drinking water supplies.

EID Corso PS, Kramer MH, Blair KA, Addiss DG, Davis JP, Haddix AC. Costs of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin. Emerg Infect Dis. 2003;9(4):426-431. https://dx.doi.org/10.3201/eid0904.020417
AMA Corso PS, Kramer MH, Blair KA, et al. Costs of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin. Emerging Infectious Diseases. 2003;9(4):426-431. doi:10.3201/eid0904.020417.
APA Corso, P. S., Kramer, M. H., Blair, K. A., Addiss, D. G., Davis, J. P., & Haddix, A. C. (2003). Costs of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin. Emerging Infectious Diseases, 9(4), 426-431. https://dx.doi.org/10.3201/eid0904.020417.

Antimicrobial-Drug Prescription in Ambulatory Care Settings, United States, 1992–2000 [PDF - 214 KB - 6 pages]
L. F. McCaig et al.

During the 1990s, as antimicrobial resistance increased among pneumococci, many organizations promoted appropriate antimicrobial use to combat resistance. We analyzed data from the National Ambulatory Medical Care Survey, an annual sample survey of visits to office-based physicians, and the National Hospital Ambulatory Medical Care Survey, an annual sample survey of visits to hospital emergency and outpatient departments, to describe trends in antimicrobial prescribing from 1992 to 2000 in the United States. Approximately 1,100–1,900 physicians reported data from 21,000–37,000 visits; 200–300 outpatient departments reported data for 28,000–35,000 visits; ~400 emergency departments reported data for 21,000–36,000 visits each year. In that period, the population- and visit-based antimicrobial prescribing rates in ambulatory care settings decreased by 23% and 25%, respectively, driven largely by a decrease in prescribing by office-based physicians. Antimicrobial prescribing rates changed as follows: amoxicillin and ampicillin, –43%; cephalosporins, –28%; erythromycin, –76%; azithromycin and clarithromycin, +388%; quinolones, +78%; and amoxicillin/clavulanate, +72%. This increasing use of azithromycin, clarithromycin, and quinolones warrants concern as macrolide- and fluoroquinolone-resistant pneumococci are increasing.

EID McCaig LF, Besser RE, Hughes JM. Antimicrobial-Drug Prescription in Ambulatory Care Settings, United States, 1992–2000. Emerg Infect Dis. 2003;9(4):432-437. https://dx.doi.org/10.3201/eid0904.020268
AMA McCaig LF, Besser RE, Hughes JM. Antimicrobial-Drug Prescription in Ambulatory Care Settings, United States, 1992–2000. Emerging Infectious Diseases. 2003;9(4):432-437. doi:10.3201/eid0904.020268.
APA McCaig, L. F., Besser, R. E., & Hughes, J. M. (2003). Antimicrobial-Drug Prescription in Ambulatory Care Settings, United States, 1992–2000. Emerging Infectious Diseases, 9(4), 432-437. https://dx.doi.org/10.3201/eid0904.020268.

Dengue Fever in Travelers to the Tropics, 1998 and 1999 [PDF - 185 KB - 5 pages]
H. Lindbäck et al.

Dengue fever (DF) has become common in western travelers to the tropics. To improve the basis for travel advice, risk factors and dengue manifestations were assessed in 107 Swedish patients for whom DF was diagnosed after return from travel in 1998 and 1999. Patient data were compared with data on a sample of all Swedish travelers to dengue-endemic countries in the same years. Only three of the patients had received pretravel advice concerning DF from their physicians. Hemorrhagic manifestations were common (21 of 74 patients) but caused no deaths. Risk factors for a DF diagnosis were travel to the Malay Peninsula (odds ratio [OR] 4.95; confidence interval [CI] 2.92 to 8.46), age 15–29 years (OR 3.03; CI 1.87 to 4.92), and travel duration >25 days (OR 8.75; CI 4.79 to 16.06). Pretravel advice should be given to all travelers to DF-endemic areas, but young persons traveling to southern and Southeast Asia for >3 weeks (who constituted 31% of the patients in our study) may be more likely to benefit by adhering to it.

EID Lindbäck H, Lindbäck J, Tegnell A, Janzon R, Vene S, Ekdahl K. Dengue Fever in Travelers to the Tropics, 1998 and 1999. Emerg Infect Dis. 2003;9(4):438-442. https://dx.doi.org/10.3201/eid0904.020267
AMA Lindbäck H, Lindbäck J, Tegnell A, et al. Dengue Fever in Travelers to the Tropics, 1998 and 1999. Emerging Infectious Diseases. 2003;9(4):438-442. doi:10.3201/eid0904.020267.
APA Lindbäck, H., Lindbäck, J., Tegnell, A., Janzon, R., Vene, S., & Ekdahl, K. (2003). Dengue Fever in Travelers to the Tropics, 1998 and 1999. Emerging Infectious Diseases, 9(4), 438-442. https://dx.doi.org/10.3201/eid0904.020267.

Risk for Severe Group A Streptococcal Disease among Patients’ Household Contacts [PDF - 187 KB - 5 pages]
K. A. Robinson et al.

From January 1997 to April 1999, we determined attack rates for cases of invasive group A streptococcal (GAS) disease in household contacts of index patients using data from Active Bacterial Core Surveillance sites. Of 680 eligible index-patient households, 525 (77.2%) were enrolled in surveillance. Of 1,514 household contacts surveyed, 127 (8.4%) sought medical care, 24 (1.6%) required hospital care, and none died during the 30-day reference period. One confirmed GAS case in a household contact was reported (attack rate, 66.1/100,000 household contacts). One household contact had severe GAS-compatible illness without confirmed etiology. Our study suggests that subsequent cases of invasive GAS disease can occur, albeit rarely. The risk estimate from this study is important for developing recommendations on the use of chemoprophylaxis for household contacts of persons with invasive GAS disease.

EID Robinson KA, Rothrock G, Phan QN, Sayler B, Stefonek K, Van Beneden C, et al. Risk for Severe Group A Streptococcal Disease among Patients’ Household Contacts. Emerg Infect Dis. 2003;9(4):443-447. https://dx.doi.org/10.3201/eid0904.020369
AMA Robinson KA, Rothrock G, Phan QN, et al. Risk for Severe Group A Streptococcal Disease among Patients’ Household Contacts. Emerging Infectious Diseases. 2003;9(4):443-447. doi:10.3201/eid0904.020369.
APA Robinson, K. A., Rothrock, G., Phan, Q. N., Sayler, B., Stefonek, K., Van Beneden, C....Levine, O. S. (2003). Risk for Severe Group A Streptococcal Disease among Patients’ Household Contacts. Emerging Infectious Diseases, 9(4), 443-447. https://dx.doi.org/10.3201/eid0904.020369.

Hepatitis E Virus Epidemiology in Industrialized Countries [PDF - 288 KB - 6 pages]
P. Clemente-Casares et al.

To determine the prevalence of Hepatitis E virus (HEV) in industrialized nations, we analyzed the excretion of HEV strains by the populations of Spain, France, Greece, Sweden, and the United States. Twenty of 46 (43.5%) urban sewage samples collected in Barcelona from 1994 to 2002 tested positive for HEV. We identified 15 HEV strains, which were similar to two HEV isolates previously described in Barcelona in clinical samples and to strains from diverse geographic HEV-nonendemic areas. We also identified two HEV strains in sewage samples from Washington, D.C., and Nancy, France; these samples were also positive for Hepatitis A virus. In addition, we studied the role of pigs as a reservoir for HEV and identified one new swine HEV strain. Our results suggest that HEV may be more prevalent than previously considered in industrialized countries and that variants of the virus circulate simultaneously in one region.

EID Clemente-Casares P, Pina S, Buti M, Jardi R, Martín M, Bofill-Mas S, et al. Hepatitis E Virus Epidemiology in Industrialized Countries. Emerg Infect Dis. 2003;9(4):449-454. https://dx.doi.org/10.3201/eid0904.020351
AMA Clemente-Casares P, Pina S, Buti M, et al. Hepatitis E Virus Epidemiology in Industrialized Countries. Emerging Infectious Diseases. 2003;9(4):449-454. doi:10.3201/eid0904.020351.
APA Clemente-Casares, P., Pina, S., Buti, M., Jardi, R., Martín, M., Bofill-Mas, S....Girones, R. (2003). Hepatitis E Virus Epidemiology in Industrialized Countries. Emerging Infectious Diseases, 9(4), 449-454. https://dx.doi.org/10.3201/eid0904.020351.

Infectious Pancreatic Necrosis Virus in Scottish Atlantic Salmon Farms, 19962001 [PDF - 416 KB - 6 pages]
A. G. Murray et al.

The rapid growth of aquaculture has provided opportunities for the emergence of diseases. Programs designed to monitor these pathogens are useful for analysis of regional variation and trends, provided methods are standardized. Data from an official monitoring program were used to analyze the emergence of infectious pancreatic necrosis virus in Scottish salmon farms from 1996 to 2001. An annual increase in the prevalence of this virus was found in saltwater (10%) and freshwater sites (2% to 3%), with a much faster increase (6.5%) in Shetland’s freshwater sites. No significant increase in the virus was detected in the marine farms of southern mainland Scotland. However, the virus had become very prevalent at marine sites and was almost ubiquitous in Shetland by 2001, and thus the prevalence of this virus at marine sites may be underestimated. Because several diseases have emerged or are emerging in fish farming, aquaculture surveillance programs represent a rich potential source of data on emerging diseases.

EID Murray AG, Busby CD, Bruno DW. Infectious Pancreatic Necrosis Virus in Scottish Atlantic Salmon Farms, 1996–2001. Emerg Infect Dis. 2003;9(4):455-460. https://dx.doi.org/10.3201/eid0904.020311
AMA Murray AG, Busby CD, Bruno DW. Infectious Pancreatic Necrosis Virus in Scottish Atlantic Salmon Farms, 1996–2001. Emerging Infectious Diseases. 2003;9(4):455-460. doi:10.3201/eid0904.020311.
APA Murray, A. G., Busby, C. D., & Bruno, D. W. (2003). Infectious Pancreatic Necrosis Virus in Scottish Atlantic Salmon Farms, 1996–2001. Emerging Infectious Diseases, 9(4), 455-460. https://dx.doi.org/10.3201/eid0904.020311.

Molecular Epidemiology of Human Enterovirus 71 Strains and Recent Outbreaks in the Asia-Pacific Region: Comparative Analysis of the VP1 and VP4 Genes [PDF - 239 KB - 7 pages]
M. J. Cardosa et al.

This study provides a comprehensive overview of the molecular epidemiology of human enterovirus 71 (HEV71) in the Asia-Pacific region from 1997 through 2002. Phylogenetic analysis of the VP4 and VP1 genes of recent HEV71 strains indicates that several genogroups of the virus have been circulating in the Asia-Pacific region since 1997. The first of these recent outbreaks, described in Sarawak (Malaysian Borneo) in 1997, was caused by genogroup B3. This outbreak was followed by large outbreaks in Taiwan in 1998, caused by genogroup C2, and in Perth (Western Australia) in 1999, where viruses belonging to genogroups B3 and C2 cocirculated. Singapore, Taiwan, and Sarawak had HEV71 epidemics in 2000, caused predominantly by viruses belonging to genogroup B4; however, large numbers of fatalities were observed only in Taiwan. HEV71 was identified during an epidemic of hand, foot and mouth disease in Korea; that epidemic was found to be due to viruses constituting a new genogroup, C3.

EID Cardosa MJ, Perera D, Brown BA, Cheon D, Chan HM, Chan KP, et al. Molecular Epidemiology of Human Enterovirus 71 Strains and Recent Outbreaks in the Asia-Pacific Region: Comparative Analysis of the VP1 and VP4 Genes. Emerg Infect Dis. 2003;9(4):462-468. https://dx.doi.org/10.3201/eid0904.020395
AMA Cardosa MJ, Perera D, Brown BA, et al. Molecular Epidemiology of Human Enterovirus 71 Strains and Recent Outbreaks in the Asia-Pacific Region: Comparative Analysis of the VP1 and VP4 Genes. Emerging Infectious Diseases. 2003;9(4):462-468. doi:10.3201/eid0904.020395.
APA Cardosa, M. J., Perera, D., Brown, B. A., Cheon, D., Chan, H. M., Chan, K. P....McMinn, P. (2003). Molecular Epidemiology of Human Enterovirus 71 Strains and Recent Outbreaks in the Asia-Pacific Region: Comparative Analysis of the VP1 and VP4 Genes. Emerging Infectious Diseases, 9(4), 462-468. https://dx.doi.org/10.3201/eid0904.020395.

Invasive Group B Streptococcal Infections in Finland: A Population-based Study [PDF - 325 KB - 4 pages]
O. Lyytikäinen et al.

We analyzed surveillance data on group B streptococcus (GBS) infection in Finland from 1995 to 2000 and reviewed neonatal cases of early-onset GBS infection in selected hospitals in 1999 to 2000. From 1995 to 2000, 853 cases were reported (annual incidence 2.2–3.0/100,000 population). We found 32–38 neonatal cases of early-onset GBS disease per year (annual incidence 0.6–0.7/1,000 live births). In five hospitals, 35% of 26 neonatal cases of early-onset GBS infection had at least one risk factor: prolonged rupture of membranes, preterm delivery, or intrapartum fever. Five of eight mothers screened for GBS were colonized. In one case, disease developed despite intrapartum chemoprophylaxis. Although the incidence of early-onset GBS disease in Finland is relatively low, some geographic variation exists, and current prevention practices are suboptimal. Establishing national guidelines to prevent perinatal GBS is likely to reduce the incidence of the disease.

EID Lyytikäinen O, Nuorti JP, Halmesmäki E, Carlson P, Uotila J, Vuento R, et al. Invasive Group B Streptococcal Infections in Finland: A Population-based Study. Emerg Infect Dis. 2003;9(4):470-473. https://dx.doi.org/10.3201/eid0904.020481
AMA Lyytikäinen O, Nuorti JP, Halmesmäki E, et al. Invasive Group B Streptococcal Infections in Finland: A Population-based Study. Emerging Infectious Diseases. 2003;9(4):470-473. doi:10.3201/eid0904.020481.
APA Lyytikäinen, O., Nuorti, J. P., Halmesmäki, E., Carlson, P., Uotila, J., Vuento, R....Järvenpää, A. (2003). Invasive Group B Streptococcal Infections in Finland: A Population-based Study. Emerging Infectious Diseases, 9(4), 470-473. https://dx.doi.org/10.3201/eid0904.020481.

Alfalfa Seed Decontamination in Salmonella Outbreak [PDF - 357 KB - 6 pages]
C. J. Gill et al.

Based on in vitro data, the U.S. Food and Drug Administration recommends chemical disinfection of raw sprout seeds to reduce enteric pathogens contaminating the seed coats. However, little is known about the effectiveness of decontamination at preventing human disease. In 1999, an outbreak of Salmonella enterica serotype Mbandaka occurred in Oregon, Washington, Idaho, and California. Based on epidemiologic and pulsed-field gel electrophoresis evidence from 87 confirmed cases, the outbreak was linked to contaminated alfalfa seeds grown in California’s Imperial Valley. Trace-back and trace-forward investigations identified a single lot of seeds used by five sprout growers during the outbreak period. Cases of salmonellosis were linked with two sprout growers who had not employed chemical disinfection; no cases were linked to three sprout growers who used disinfection. This natural experiment provides empiric evidence that chemical disinfection can reduce the human risk for disease posed by contaminated seed sprouts.

EID Gill CJ, Keene WE, Mohle-Boetani JC, Farrar JA, Waller PL, Hahn CG, et al. Alfalfa Seed Decontamination in Salmonella Outbreak. Emerg Infect Dis. 2003;9(4):474-479. https://dx.doi.org/10.3201/eid0904.020519
AMA Gill CJ, Keene WE, Mohle-Boetani JC, et al. Alfalfa Seed Decontamination in Salmonella Outbreak. Emerging Infectious Diseases. 2003;9(4):474-479. doi:10.3201/eid0904.020519.
APA Gill, C. J., Keene, W. E., Mohle-Boetani, J. C., Farrar, J. A., Waller, P. L., Hahn, C. G....Cieslak, P. R. (2003). Alfalfa Seed Decontamination in Salmonella Outbreak. Emerging Infectious Diseases, 9(4), 474-479. https://dx.doi.org/10.3201/eid0904.020519.
Dispatches

Scrub Typhus in the Torres Strait Islands of North Queensland, Australia [PDF - 213 KB - 3 pages]
A. G. Faa et al.

Scrub typhus, caused by Orientia tsutsugamushi, occurs throughout Southeast Asia. We descript ten cases that occurred in the Torres Strait islands of northern Australia during 2000 and 2001. Preceding heavy rain may have contributed to the outbreak. The successful use of azithromycin in two pediatric patients is also reported.

EID Faa AG, McBride WJ, Garstone G, Thompson RE, Holt P. Scrub Typhus in the Torres Strait Islands of North Queensland, Australia. Emerg Infect Dis. 2003;9(4):480-482. https://dx.doi.org/10.3201/eid0904.020509
AMA Faa AG, McBride WJ, Garstone G, et al. Scrub Typhus in the Torres Strait Islands of North Queensland, Australia. Emerging Infectious Diseases. 2003;9(4):480-482. doi:10.3201/eid0904.020509.
APA Faa, A. G., McBride, W. J., Garstone, G., Thompson, R. E., & Holt, P. (2003). Scrub Typhus in the Torres Strait Islands of North Queensland, Australia. Emerging Infectious Diseases, 9(4), 480-482. https://dx.doi.org/10.3201/eid0904.020509.

Early-Season Avian Deaths from West Nile Virus as Warnings of Human Infection [PDF - 196 KB - 2 pages]
S. C. Guptill et al.

An analysis of 2001 and 2002 West Nile virus (WNV) surveillance data shows that counties that report WNV-infected dead birds early in the transmission season are more likely to report subsequent WNV disease cases in humans than are counties that do not report early WNV-infected dead birds.

EID Guptill SC, Julian KG, Campbell GL, Price SD, Marfin AA. Early-Season Avian Deaths from West Nile Virus as Warnings of Human Infection. Emerg Infect Dis. 2003;9(4):483-484. https://dx.doi.org/10.3201/eid0904.020421
AMA Guptill SC, Julian KG, Campbell GL, et al. Early-Season Avian Deaths from West Nile Virus as Warnings of Human Infection. Emerging Infectious Diseases. 2003;9(4):483-484. doi:10.3201/eid0904.020421.
APA Guptill, S. C., Julian, K. G., Campbell, G. L., Price, S. D., & Marfin, A. A. (2003). Early-Season Avian Deaths from West Nile Virus as Warnings of Human Infection. Emerging Infectious Diseases, 9(4), 483-484. https://dx.doi.org/10.3201/eid0904.020421.

Human Neurobrucellosis with Intracerebral Granuloma Caused by a Marine Mammal Brucella spp. [PDF - 303 KB - 4 pages]
A. H. Sohn et al.

We present the first report of community-acquired human infections with marine mammal–associated Brucella spp. and describe the identification of these strains in two patients with neurobrucellosis and intracerebral granulomas. The identification of these isolates as marine mammal strains was based on omp2a sequence and amplification of the region flanking bp26.

EID Sohn AH, Probert WS, Glaser CA, Gupta N, Bollen AW, Wong JD, et al. Human Neurobrucellosis with Intracerebral Granuloma Caused by a Marine Mammal Brucella spp.. Emerg Infect Dis. 2003;9(4):485-488. https://dx.doi.org/10.3201/eid0904.020576
AMA Sohn AH, Probert WS, Glaser CA, et al. Human Neurobrucellosis with Intracerebral Granuloma Caused by a Marine Mammal Brucella spp.. Emerging Infectious Diseases. 2003;9(4):485-488. doi:10.3201/eid0904.020576.
APA Sohn, A. H., Probert, W. S., Glaser, C. A., Gupta, N., Bollen, A. W., Wong, J. D....McDonald, W. C. (2003). Human Neurobrucellosis with Intracerebral Granuloma Caused by a Marine Mammal Brucella spp.. Emerging Infectious Diseases, 9(4), 485-488. https://dx.doi.org/10.3201/eid0904.020576.

Antimicrobial Growth Promoters and Salmonella spp., Campylobacter spp. in Poultry and Swine, Denmark [PDF - 397 KB - 4 pages]
M. C. Evans and H. C. Wegener

The use of antimicrobial growth promoters in Danish food animal production was discontinued in 1998. Contrary to concerns that pathogen load would increase; we found a significant decrease in Salmonella in broilers before and after slaughter of swine and pork and no change in the prevalence of Campylobacter in broilers.

EID Evans MC, Wegener HC. Antimicrobial Growth Promoters and Salmonella spp., Campylobacter spp. in Poultry and Swine, Denmark. Emerg Infect Dis. 2003;9(4):489-492. https://dx.doi.org/10.3201/eid0904.020325
AMA Evans MC, Wegener HC. Antimicrobial Growth Promoters and Salmonella spp., Campylobacter spp. in Poultry and Swine, Denmark. Emerging Infectious Diseases. 2003;9(4):489-492. doi:10.3201/eid0904.020325.
APA Evans, M. C., & Wegener, H. C. (2003). Antimicrobial Growth Promoters and Salmonella spp., Campylobacter spp. in Poultry and Swine, Denmark. Emerging Infectious Diseases, 9(4), 489-492. https://dx.doi.org/10.3201/eid0904.020325.

First Incursion of Salmonella enterica Serotype Typhimurium DT160 into New Zealand [PDF - 200 KB - 3 pages]
C. N. Thornley et al.

An outbreak of human Salmonella enterica serotype Typhimurium DT160 infection in New Zealand was investigated from May to August 2001. Handling of dead wild birds, contact with persons with diarrheal illness, and consumption of fast food were associated with infection. Contaminated roof-collected rainwater was also detected.

EID Thornley CN, Simmons GC, Callaghan ML, Nicol CM, Baker MG, Gilmore KS, et al. First Incursion of Salmonella enterica Serotype Typhimurium DT160 into New Zealand. Emerg Infect Dis. 2003;9(4):493-495. https://dx.doi.org/10.3201/eid0904.020439
AMA Thornley CN, Simmons GC, Callaghan ML, et al. First Incursion of Salmonella enterica Serotype Typhimurium DT160 into New Zealand. Emerging Infectious Diseases. 2003;9(4):493-495. doi:10.3201/eid0904.020439.
APA Thornley, C. N., Simmons, G. C., Callaghan, M. L., Nicol, C. M., Baker, M. G., Gilmore, K. S....Garrett, N. K. (2003). First Incursion of Salmonella enterica Serotype Typhimurium DT160 into New Zealand. Emerging Infectious Diseases, 9(4), 493-495. https://dx.doi.org/10.3201/eid0904.020439.

Automated Ribotyping and Pulsed-Field Gel Electrophoresis for Rapid Identification of Multidrug-Resistant Salmonella Serotype Newport [PDF - 350 KB - 4 pages]
J. Fontana et al.

In a series of 116 Salmonella enterica Newport isolates that included 64 multidrug-resistant (MDR) isolates, automated ribotyping and pulsed-field gel electrophoresis (PFGE) discriminated MDR S. Newport with a sensitivity of 100% and 98% and specificity of 76% and 89%, respectively. Clustering of PFGE patterns (but not ribotyping) linked human and bovine cases. Automated ribotyping rapidly identified the MDR strain, and PFGE detected associations that aided epidemiologic investigations.

EID Fontana J, Stout A, Bolstorff B, Timperi R. Automated Ribotyping and Pulsed-Field Gel Electrophoresis for Rapid Identification of Multidrug-Resistant Salmonella Serotype Newport. Emerg Infect Dis. 2003;9(4):496-499. https://dx.doi.org/10.3201/eid0904.020423
AMA Fontana J, Stout A, Bolstorff B, et al. Automated Ribotyping and Pulsed-Field Gel Electrophoresis for Rapid Identification of Multidrug-Resistant Salmonella Serotype Newport. Emerging Infectious Diseases. 2003;9(4):496-499. doi:10.3201/eid0904.020423.
APA Fontana, J., Stout, A., Bolstorff, B., & Timperi, R. (2003). Automated Ribotyping and Pulsed-Field Gel Electrophoresis for Rapid Identification of Multidrug-Resistant Salmonella Serotype Newport. Emerging Infectious Diseases, 9(4), 496-499. https://dx.doi.org/10.3201/eid0904.020423.

Class I Integrons and SXT Elements in El Tor Strains Isolated before and after 1992 Vibrio cholerae O139 Outbreak, Calcutta, India [PDF - 211 KB - 3 pages]
M. Amita et al.

We examined the distribution of class I integrons and SXT elements in Vibrio cholerae O1 El Tor strains, isolated in Calcutta, India, before and after the V. cholerae O139 outbreak in 1992. Class I integrons, with aadA1 gene cassette, were detected primarily in the pre-O139 strains; the SXT element was found mainly in the post-O139 strains.

EID Amita M, Chowdhury SR, Thungapathra M, Ramamurthy T, Nair GB, Ghosh A. Class I Integrons and SXT Elements in El Tor Strains Isolated before and after 1992 Vibrio cholerae O139 Outbreak, Calcutta, India. Emerg Infect Dis. 2003;9(4):500-502. https://dx.doi.org/10.3201/eid0904.020317
AMA Amita M, Chowdhury SR, Thungapathra M, et al. Class I Integrons and SXT Elements in El Tor Strains Isolated before and after 1992 Vibrio cholerae O139 Outbreak, Calcutta, India. Emerging Infectious Diseases. 2003;9(4):500-502. doi:10.3201/eid0904.020317.
APA Amita, M., Chowdhury, S. R., Thungapathra, M., Ramamurthy, T., Nair, G. B., & Ghosh, A. (2003). Class I Integrons and SXT Elements in El Tor Strains Isolated before and after 1992 Vibrio cholerae O139 Outbreak, Calcutta, India. Emerging Infectious Diseases, 9(4), 500-502. https://dx.doi.org/10.3201/eid0904.020317.

Fear of Bioterrorism and Implications for Public Health Preparedness [PDF - 183 KB - 3 pages]
M. S. Dworkin et al.

After the human anthrax cases and exposures in 2001, the Illinois Department of Public Health received an increasing number of environmental and human samples (1,496 environmental submissions, all negative for Bacillus anthracis). These data demonstrate increased volume of submissions to a public health laboratory resulting from fear of bioterrorism.

EID Dworkin MS, Ma X, Golash RG. Fear of Bioterrorism and Implications for Public Health Preparedness. Emerg Infect Dis. 2003;9(4):503-505. https://dx.doi.org/10.3201/eid0904.020593
AMA Dworkin MS, Ma X, Golash RG. Fear of Bioterrorism and Implications for Public Health Preparedness. Emerging Infectious Diseases. 2003;9(4):503-505. doi:10.3201/eid0904.020593.
APA Dworkin, M. S., Ma, X., & Golash, R. G. (2003). Fear of Bioterrorism and Implications for Public Health Preparedness. Emerging Infectious Diseases, 9(4), 503-505. https://dx.doi.org/10.3201/eid0904.020593.
Another Dimension

Cicero and Burkholderia cepacia: What’s in a Name? [PDF - 148 KB - 2 pages]
J. E. Moore and F. Williams

Then said they unto him, Say now Shibboleth: and he said Sibboleth: for he could not frame to pronounce it right. Then they took him and slew him at the passes of Jordan: and there fell at that time of the Ephraimites forty and two thousand. Judges 12:6

EID Moore JE, Williams F. Cicero and Burkholderia cepacia: What’s in a Name?. Emerg Infect Dis. 2003;9(4):506-507. https://dx.doi.org/10.3201/eid0904.ad0904
AMA Moore JE, Williams F. Cicero and Burkholderia cepacia: What’s in a Name?. Emerging Infectious Diseases. 2003;9(4):506-507. doi:10.3201/eid0904.ad0904.
APA Moore, J. E., & Williams, F. (2003). Cicero and Burkholderia cepacia: What’s in a Name?. Emerging Infectious Diseases, 9(4), 506-507. https://dx.doi.org/10.3201/eid0904.ad0904.
Books and Media

Travellers’ Health: How to Stay Healthy Abroad, 4th edition [PDF - 115 KB - 1 page]
P. J. Baxter
EID Baxter PJ. Travellers’ Health: How to Stay Healthy Abroad, 4th edition. Emerg Infect Dis. 2003;9(4):508. https://dx.doi.org/10.3201/eid0904.030005
AMA Baxter PJ. Travellers’ Health: How to Stay Healthy Abroad, 4th edition. Emerging Infectious Diseases. 2003;9(4):508. doi:10.3201/eid0904.030005.
APA Baxter, P. J. (2003). Travellers’ Health: How to Stay Healthy Abroad, 4th edition. Emerging Infectious Diseases, 9(4), 508. https://dx.doi.org/10.3201/eid0904.030005.

Product Review: MicrobeCards
K. S. Hagen
EID Hagen KS. Product Review: MicrobeCards. Emerg Infect Dis. 2003;9(4):508-509. https://dx.doi.org/10.3201/eid0904.030055
AMA Hagen KS. Product Review: MicrobeCards. Emerging Infectious Diseases. 2003;9(4):508-509. doi:10.3201/eid0904.030055.
APA Hagen, K. S. (2003). Product Review: MicrobeCards. Emerging Infectious Diseases, 9(4), 508-509. https://dx.doi.org/10.3201/eid0904.030055.
About the Cover

Frank Day, Konkow Maidu (1902–1976). The Water Test (c. 1970–1975). [PDF - 136 KB - 1 page]
P. Potter
EID Potter P. Frank Day, Konkow Maidu (1902–1976). The Water Test (c. 1970–1975).. Emerg Infect Dis. 2003;9(4):512. https://dx.doi.org/10.3201/eid0904.ac0904
AMA Potter P. Frank Day, Konkow Maidu (1902–1976). The Water Test (c. 1970–1975).. Emerging Infectious Diseases. 2003;9(4):512. doi:10.3201/eid0904.ac0904.
APA Potter, P. (2003). Frank Day, Konkow Maidu (1902–1976). The Water Test (c. 1970–1975).. Emerging Infectious Diseases, 9(4), 512. https://dx.doi.org/10.3201/eid0904.ac0904.
Conference Summaries

Converging Issues in Veterinary and Public Health [PDF - 144 KB - 2 pages]
L. King and R. Khabbaz
EID King L, Khabbaz R. Converging Issues in Veterinary and Public Health. Emerg Infect Dis. 2003;9(4):510-511. https://dx.doi.org/10.3201/eid0904.030037
AMA King L, Khabbaz R. Converging Issues in Veterinary and Public Health. Emerging Infectious Diseases. 2003;9(4):510-511. doi:10.3201/eid0904.030037.
APA King, L., & Khabbaz, R. (2003). Converging Issues in Veterinary and Public Health. Emerging Infectious Diseases, 9(4), 510-511. https://dx.doi.org/10.3201/eid0904.030037.
Corrections

Correction, Vol. 8, No. 10
EID Correction, Vol. 8, No. 10. Emerg Infect Dis. 2003;9(4):511. https://dx.doi.org/10.3201/eid0904.c10904
AMA Correction, Vol. 8, No. 10. Emerging Infectious Diseases. 2003;9(4):511. doi:10.3201/eid0904.c10904.
APA (2003). Correction, Vol. 8, No. 10. Emerging Infectious Diseases, 9(4), 511. https://dx.doi.org/10.3201/eid0904.c10904.
Page created: July 10, 2012
Page updated: July 10, 2012
Page reviewed: July 10, 2012
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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